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Maximise your benefit - Visit an In Network Provider

Your benefits are contractually better at a network provider - Scheme rules apply

To confirm that you or a dependent is entitled to optical benefit, SMS your request to 45119 with the following details:

Benefit,MembershipNumber,Surname,BirthDateDependent,MainMemberID,DependantNumber, UniqueMedicalAid Key

Example: SMS 45119 Message details: Benefit 277323232 Botha 19721220 7212205065089 0 96

Important information:

Replace each comma with a space in your SMS and ensure the details are accurate and only one space is between each requirement. Kindly make sure the birthdate is in the correct format as per the example. The information will return within 1 minute on a new SMS. The full benefit breakdown per dependent is available by logging in to the PPN website or a guideline is given below. Your schemes unique medical key is 96.

Guardian

2022 Optical Benefits:

Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.

Member can claim either Spectacles OR Contact Lenses

Forensic protocols and AI screening included in design

The benefits are a guideline and scheme rules apply

Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)

Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350

  • IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 950
OR
  • OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 760
AND
  • One pair of either Single Vision or Bifocal or Multifocal clear standard lenses

Contact lenses: R 1 325 per beneficiary

Select

2022 Optical Benefit:

Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.

Member can claim either Spectacles OR Contact Lenses

Forensic protocols and AI screening included in design

The benefits are a guideline and scheme rules apply

Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)

Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350

IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 1 000
OR
OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 800
AND
One pair of either Single Vision or Bifocal or Multifocal clear standard lenses

Contact lenses: R 1 380 per beneficiary

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